Rebecca Gonzalez v. Fresenius Medical Care

CourtCourt of Appeals for the Fifth Circuit
DecidedJuly 30, 2012
Docket10-50413
StatusPublished

This text of Rebecca Gonzalez v. Fresenius Medical Care (Rebecca Gonzalez v. Fresenius Medical Care) is published on Counsel Stack Legal Research, covering Court of Appeals for the Fifth Circuit primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Rebecca Gonzalez v. Fresenius Medical Care, (5th Cir. 2012).

Opinion

Case: 10-50413 Document: 00511937803 Page: 1 Date Filed: 07/30/2012

IN THE UNITED STATES COURT OF APPEALS FOR THE FIFTH CIRCUIT United States Court of Appeals Fifth Circuit

FILED July 30, 2012

No. 10-50413 Lyle W. Cayce Clerk

REBECCA GONZALEZ,

Plaintiff-Appellant v.

FRESENIUS MEDICAL CARE NORTH AMERICA; ALFONSO CHAVEZ, M.D.,

Defendants-Appellees

------------------------------------------------------------------------------------------------------------ consolidated with Case No. 10-51171

FRESENIUS MEDICAL CARE NORTH AMERICA; ALFONZO CHAVEZ, M.D.; LARRY RAMIREZ; BIO-MEDICAL APPLICATIONS OF TEXAS, INC.; FRESENIUS MEDICAL CARE HOLDINGS, INC.,

Appeals from the United States District Court for the Western District of Texas Case: 10-50413 Document: 00511937803 Page: 2 Date Filed: 07/30/2012

No. 10-50413

Before GARZA, DENNIS, and HIGGINSON, Circuit Judges. GARZA, Circuit Judge: Plaintiff-Appellant Rebecca Gonzalez (“Relator”) brought a qui tam action under the False Claims Act (“FCA”), 31 U.S.C. § 3729 et seq., against Defendants-Appellees Fresenius Medical Care North America, Fresenius Medical Care Holdings, Inc., Bio-Medical Applications of Texas, Inc. (collectively, “Fresenius”), and Alfonzo Chavez, M.D. Relator also brought retaliation claims against Fresenius and her former supervisor Larry Ramirez. The district court granted in part and denied in part the defendants’ motions for judgment as a matter of law, and the jury returned a verdict in favor of the defendants on the remaining claims. The district court then awarded Fresenius $15,360 in attorney’s fees from Relator’s counsel under 28 U.S.C. § 1927. Relator now appeals the district court’s judgment with respect to her FCA and retaliation claims. Relator’s counsel also appeals the award of attorneys’ fees. We affirm the judgment of the district court in all instances. I Fresenius is a provider of dialysis services to patients with end stage renal disease (ESRD).1 Chavez is a nephrologist2 serving as the medical director and attending physician at two of Fresenius’s clinics. Relator’s Fourth Amended Complaint alleged that while she was employed by Fresenius, Fresenius and Chavez submitted false claims to Medicare in violation of the FCA. Specifically, Relator alleged that Ramiro Devora and Arturo Orozco (“assistants”), two

1 “[ESRD] is when the kidneys are no longer able to work at a level needed for day-to- day life” and “almost always comes after chronic kidney disease.” END STAGE KIDNEY DISEASE, http://www.nlm.nih.gov/medlineplus/ency/article/000500.htm (last visited, Mar. 27, 2012). “The most common causes of ESRD in the U.S. are diabetes and high blood pressure[,]” and “[d]ialysis or kidney transplantation is the only treatment for this condition.” Id. 2 A nephrologist is a medical specialist in nephrology, a branch of medical science concerned with medical diseases of the kidney. STEDMAN’S MEDICAL DICTIONARY (27th ed. 2000).

2 Case: 10-50413 Document: 00511937803 Page: 3 Date Filed: 07/30/2012

non-physicians who worked for Chavez, performed tasks and made patient-care decisions at Fresenius clinics in violation of state and federal regulations, and that Chavez billed Medicare for his assistants’ work. Relator also contended that, in return for Fresenius overlooking his illegal use of assistants, Chavez referred patients from his private practice to Fresenius in violation of federal anti-kickback laws. After filing her qui tam action, Relator filed a separate complaint against Fresenius and Ramirez alleging that, in retaliation for her qui tam action, she was harassed, threatened, and eventually forced to resign. The district court consolidated Relator’s qui tam and retaliation actions, and Fresenius and Chavez filed motions to dismiss portions of Relator’s complaints. The court granted the motions, leaving the following causes of action from the FCA Complaint viable at the start of trial: Count 1 (knowingly presenting fraudulent or false claims in violation of the FCA, § 3729(a)(1)); Count 2 (knowingly making a false record or statement in presentation of false claims in violation of the FCA, § 3729(a)(2)); Count 3 (presenting false claims for Medicare reimbursement for services rendered in violation of the Stark Law, 42 U.S.C. § 1395nn); Count 6 (presenting false claims for Medicare reimbursement for services rendered in violation of the Anti-Kickback Act, 42 U.S.C. §§ 1320a-7b(b)); and Count 7 (conspiring to submit false claims in violation of the FCA, § 3729(a)(3)). The following causes of action from the Retaliation Complaint were viable at the start of trial: Count 1 (retaliation in violation of the FCA, § 3730(h)), as against Fresenius; Count 2 (retaliatory constructive discharge in violation of the FCA, § 3730(h)), as against Fresenius; and Count 3 (intentional infliction of emotional distress) as against Fresenius and Ramirez. Relator, Fresenius, and Chavez all filed motions for summary judgment, which the court carried through trial. At the close of Relator’s case-in-chief, Fresenius and Chavez moved for judgment as a matter of law. The district court granted the motions in part and

3 Case: 10-50413 Document: 00511937803 Page: 4 Date Filed: 07/30/2012

denied them in part, holding the defendants were entitled to judgment as a matter of law on Counts 1, 3, and 6 of the FCA Complaint, and Counts 1, 2, and 3 of the Retaliation Complaint. The court also concluded that, because Fresenius obtained judgment as a matter of law as to Count 1 of the FCA Complaint (knowingly presenting false claims, § 3729(a)(1)), only false claims by Chavez could form the basis for either Chavez’s or Fresenius’s liability under § 3729(a)(2) (false records or statements) or § 3729(a)(3) (conspiracy). The district court then submitted the following claims to the jury: Count 1 of the FCA Complaint (knowingly presenting false claims) as against Chavez only; Count 2 of the FCA Complaint (false records or statements) as against Chavez and Fresenius; and Count 7 of the FCA Complaint (conspiring to submit false claims) as against Chavez and Fresenius. The jury returned a verdict in favor of the defendants on all three counts. Following the entry of judgment, all of the defendants moved for attorney’s fees. Fresenius and Ramirez requested fees arising from their defense of Relator’s retaliation claim, and Chavez requested fees for the entire lawsuit. The court awarded Fresenius $15,360 in attorney’s fees from Relator’s counsel under § 1927, finding that counsel unreasonably and vexatiously multiplied proceedings with respect to the retaliation suit. Relator timely appealed the district court’s judgment in the FCA/retaliation case, and Relator’s counsel separately appealed the award of attorney’s fees. We consolidated the two appeals. II Relator first contends that the district court erred in granting Fresenius judgment as a matter of law on Count 1 of the FCA Complaint (knowingly presenting false claims, § 3729(a)(1)). She bases her argument on two separate legal theories: (1) that Fresenius falsely certified compliance with applicable statutes and regulations and (2) that Fresenius assisted in the presentation of

4 Case: 10-50413 Document: 00511937803 Page: 5 Date Filed: 07/30/2012

claims that were “grounded in fraud.”3 We review the district court’s grant of judgment as a matter of law de novo, applying the same legal standards as the district court. Price v.

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Bluebook (online)
Rebecca Gonzalez v. Fresenius Medical Care, Counsel Stack Legal Research, https://law.counselstack.com/opinion/rebecca-gonzalez-v-fresenius-medical-care-ca5-2012.